Endoscopic surgical techniques, including laparoscopic and arthroscopic techniques, are gaining wide acceptance and are being increasingly used. There are many benefits associated with these minimally invasive techniques, which include, reduced patient trauma, reduced risk of post-operative infection and reduced recovery time.
Various types of surgical instruments have been developed for use with these endoscopic surgical techniques and procedures, including clip appliers for the occlusion and ligation of vessels as well as other conduits and tissue structures.
Conventional clip appliers, as currently used in these endoscopic procedures, typically consist of an elongate body having a proximal end connected to an actuating mechanism and a pair of clip compressing devices or jaws supported at the distal end. In one configuration, the jaws typically consist of a pair of opposing jaw members which are movable with respect to each other. Each of the jaw members may include a slot or other means for retaining an associated leg of a surgical clip. In this configuration, the jaws are moved relative to each other when a surgeon operates an actuating handle coupled to the actuating mechanism. In some appliers, multiple surgical clips are supported in the elongate body and moved distally, one at a time, into the jaw members in preparation for being applied to a section of tissue.
A conventional ligating clip typically includes a pair of symmetrical legs connected to an apex. The legs may extend outwardly from the apex to form a U or V-shaped clip. In use, the legs are passed over the desired section of tissue and then compressed to clip onto the tissue.
There are several deficiencies associated with the conventional clip appliers as described and as currently used. For instance, when using a conventional clip applier in an endoscopic procedure, the elongated body, or alternatively, the jaws are loaded with at least one open surgical clip in preparation for surrounding the vessel or other tissue. The jaws are then closed and the clip applier inserted through a trocar cannula so that the clip may be positioned adjacent the vessel or other tissue. The jaws are then opened and the clip compressed onto the vessel or tissue.
The size of the vessel or tissue to be clipped is limited by the size of the available clip. In general, a larger vessel or section of tissue requires a larger clip. However, since the clip applier must pass through the cannula of the trocar, its overall outer diameter must be less than that of the cannula. Also, since the clips are typically stored within the elongate body, the overall outer diameter of the clip applier may limit the size of the clips. Thus, there is a need for a clip applier which can be used with conventional trocars but which is not limited to conventional sized clips.
Another deficiency associated with conventional clip appliers is the inability to test a proposed clip site or clip location. For example, it would be beneficial to know whether a given section of tissue will actually occlude or properly ligate when clipped, without actually applying a clip to that section of tissue. There is also a need for such a clip applier and associated surgical clip which is simple to operate and relatively inexpensive to manufacture.